MRI scan (pituitary gland)

[Rachel_Christina]

Hey all.
I just got home from work to find a letter for me for an MRI scan on Monday to check my pituitary gland.
I'm gonna be honest I feel sick with worry. It was sent by my endocrinologist, who a few months ago took my first blood tests in Ireland.
I don't understand this thing at all.
Is this normal procedure for trans people?
Has he picked up something?
Or is this just something where they are looking to compile studies of trans people's brains?
There is no sign of a reason on the letter... :/

[GingerVicki]

I've never heard of that.

[Dena]

What I would suspect is your test for Prolactin came back higher than normal. Prolactin can rise because your on hormones and they can also rise because of a growth on the pituitary gland. Sometimes but not always surgery may be required however it has happed to a few site member and none have had surgery. It would be best not to worry at this point because it's probably nothing and the doctor is being cautious.

[Another Nikki]

The UCSF page on trans hrt mentions pituitary prolactinoma as a potential side effect of estrogen therapy.  I'll send you a couple links by pm.

[Rachel_Christina]

Thanks for the responses. What will this mean? Will I have to lessen my Hormones or something?
It all sounds so serious

[Michelle_P]

Thanks for the responses. What will this mean? Will I have to lessen my Hormones or something?
It all sounds so serious

The scan will help spot the presence of an adenoma, a growth, on the pituitary.  It is probably ordered because of a high prolactin level found by an endocrine panel of tests.

I have an adenoma, about 5 mm in size, on the pituitary.  It is associated with a high prolactin level tha made my Endocrinologist cautious about starting HRT, specifically Estradiol, which could stimulate the adenoma.  Normal for AMAB is 0-18 ng/ml; my levels:

Before HRT: 30 ng/mL and 34 ng/mL
2 days into estrogen: 40 ng/mL
4+ weeks on estrogen: 38 ng/mL

Ah, but the standard prolactin test isn't clever enough to tell the difference between monomeric prolactin, the stuff that helps us start nursing, and the giant macroprolactin molecules often produced by a prolactinoma that are inert.  A chromatographic test that separates them shows monomeric prolactin at 9 (normal range 3.4-14..  So my little monster is just a boring microprolactinoma and won't be causing me any problems with growth or lactation.

There's a really cheap test that measures the amount of actual real prolactin, compared to macroprolactin, huge molecules that test like prolactin but are actually inert and harmless.  You might nudge your endocrinologist to try that test.  It takes several days to get results back, but it can do wonders to set your mind at ease. (Macroprolactin, Serum; Test ID MCRPL)

If the microprolactinoma does grow, there is another medication I can take for a while that has very good results in shrinking these growths.  Surgery for these is pretty rare, but the procedure is straightforward and doesn't leave any visible scars.

[Cindy]

As Michelle said it is a screen for a growth on the pituitary gland. Having a growth does not mean you have cancer.

Some medics like having the scan as it reassures them that there isn't anything wrong with the bottom of the skull area which is a rather difficult area to assess otherwise.

The scan only takes a few minutes and is completely painless.

Looking for a prolactinoma is good practice for trans-health medics. It sounds as if you are in good hands

[Rachel_Christina]

Thank you guys for the reasurance guys. I'm naturally a little worried but I have postponed the scan till the 27th as it was originally set for the day I take my dad for a biopsy of his prostate so I can't not be there.
Hopefully it is nothing serious.
Maybe it's just protocol out here.
I don't know any Irish trans people so just don't know the procedures here

[pamelatransuk]

Hello Rachel_Christina

I have just read this thread and it reminded me to update my "Prolactin Queries" thread which I have just done; it covers the same subject as your thread and Michelle and Cindy very kindly provided advice therein.

You may wish to read the thread at least to know the method of conversion US to Intl and vice versa.

As you may see, my previous Prolactin problem resolved itself but it will be monitored in future.

I wish you the best of luck on 27Dec and that like me there will be nothing seriously wrong.

Hugs

Pamela

[Rachel_Christina]

Hey guys! I had my MRI scan today. Totally nowhere near as scary as everything on the internet makes out. I was literally falling asleep. The cradle for the head is really comfortable, the loud noises made small vibrations that where literally putting me to bed. Hardest part was holding onto the panic button thing, which I totally didn't need anyway.
They also injected me with the contrast fluid half way through. No Biggie either, just the typical feeling of getting blood taken.
Now it's gonna be another waiting game for the results.

The people dealing with me in the hospital where so lovely. Treated like anyone else. Using my proper name even with me still being officially named my old name on all official documents.
Lovely people and actually a nice hospital in Belfast (and I hate hospitals)

Anyway just an update on this for anyone interested.

[Michelle_P]

@Rachel_Christina I am glad to read you had a good experience at the hospital and being scanned.  It's nice to be working with polite and considerate caregivers.

I hope you also have good results from the scan.

Thank you for the update!

[Rachel_Christina]

@Rachel_Christina I am glad to read you had a good experience at the hospital and being scanned.  It's nice to be working with polite and considerate caregivers.

I hope you also have good results from the scan.

Thank you for the update!

Thanks Michelle, It really is a pleasure to be fair.
And yes I hope now for good results.
I'm due to be getting my first prescription filled via the UK system tomorrow. We'll see how that goes too :')

[davina61]

Had an MRI on my wrist 2 weeks ago , got my appointment to see consultant today for 8th Jan so hope yours is quicker. That tunnel is tight for a FB like me!!!!! Hope it all turns out OK and yippee on starting meds.

[Rachel_Christina]

The whole system is smaller than what I was expecting Davina for sure. Haha but I fitted in no bother.
Suppose it really was only my head and shoulders.
And yes this will be me finally switched over to getting my HRT through the UK system.
They are keeping me in the same meds as in Switzerland

[Rachel_Christina]

Hey guys, thought I should at least update this thing.
Doctors was perfectly happy with the scan results. All is normal apparently :')

[pamelatransuk]

I am so glad to hear that piece of news. I am sure you are more than relieved.

I wish you happiness for the future.

Hugs

Pamela

[Rachel_Christina]

Thank you Pamela.
He left me hanging for quite a while lol.
Thank god though.

[NatalieRene]

Hey guys, thought I should at least update this thing.
Doctors was perfectly happy with the scan results. All is normal apparently :')

This is the first that I saw this thread and it started off very scary. I'm so glad that everything was ok and that you're alright.

[Rachel_Christina]

This is the first that I saw this thread and it started off very scary. I'm so glad that everything was ok and that you're alright.

It most definitely was a scary period of time. Thank god it's over and the news is good. Imagine I had to return to living as a guy or something like that? D:

[NatalieRene]

It most definitely was a scary period of time. Thank god it's over and the news is good. Imagine I had to return to living as a guy or something like that? D:

Oh my God. I would say get an orchi and you wouldn't go back to looking like a guy but you would probably balloon up without a hormone. It would be horrible.

Thank goodness you don't have to worry about it anymore!